Provider Demographics
NPI:1336325232
Name:DUANY JIMENEZ, VIRGINIA CECILE (DO)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:CECILE
Last Name:DUANY JIMENEZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:C
Other - Last Name:DUANY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3975 ROBINSON RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NC
Mailing Address - Zip Code:28658-9715
Mailing Address - Country:US
Mailing Address - Phone:828-466-0466
Mailing Address - Fax:828-466-8862
Practice Address - Street 1:3975 ROBINSON RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NC
Practice Address - Zip Code:28658
Practice Address - Country:US
Practice Address - Phone:828-466-0466
Practice Address - Fax:828-466-8862
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200701878207Q00000X
NC2007-01878207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC148G7OtherNC BLUE CROSS BLUE SHIELD
NC5908876Medicaid
NC2007-01878OtherLICENSE
NC2007-01878OtherLICENSE